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At least 19 recordsLinked to original sources

The challenge of biophysics to dynamic dermatology.

Dermatologic biophysics has much to offer both clinical and investigative dermatology. For the clinician, the radiation biophysicist can provide accurate measurements of ionizing and nonionizing outputs, including those for PUVA, and critical evaluation of radiation safety measures. In optics, there is a need for accurate measurements of skin color and examination of the skin at moderate magnification. The biophysicist, with the biomedical engineer, can improve all the physical modality instrumentation used in practice. In investigative dermatology, there is the cellular biophysics of radiation. Doppler techniques for skin circulation, spectroscopy of living cells, and many other applications are suggested for current and future studies.

Biophysical Phenomena

Primary closure of pilonidal cystectomy.

A method of primary closure following excision of pilonidal cysts and sinus was used in 38 cases. The criteria for patient selection are described as is the technique and procedure. Special attention must be placed on the obliteration of all "dead spaces" to eliminate accumulation of serum and blood. The dressing is not changed for a minimum of eight days, and pressure must be maintained for that time to assure success. In all cases complete closure was obtained. The advantages of this technique over the open procedure is explained.

Dermatologic Surgical Procedures

Forehead and brow lifts and their relationship to blepharoplasty.

The brows and forehead are important considerations in planning a blepharoplasty. Forehead wrinkles, ptotic brows, and frown lines can be corrected effectively and safely with minimal complications at the time of, and prior to, the blepharoplasty. Various approaches that we use are presented here. The surgical procedure selected should reflect the defect present and the surgeon's preference.

Blepharoptosis

[Reconsideration of transureteral cutaneous ureterostomy: Y-shaped cutaneous ureterostomy (author's transl)].

After reviewing the history and technique used for transureteral cutaneous ureterostomy, the authors describe 5 cases treated by this method during the 3-year period, 1975--1977. This prodecure has many advantages when compared to the transintestinal cutaneous ureterostomy as described by Bricker, uteterosigmoidoscopy, and "double-barreleed" cutaneous ureterostomy. The authors conclude that transureteral cutaneous ureterostomy should be performed in cases of ureteropyelocalicial distention with renal failure from operable or inoperable bladder cancer, in women with inoperable or recurrent tumors of the genital organs and vesicovaginal, vesicourethrovaginal or vesicorectovaginal fistulae, and in patients with a neurological bladder. They propose that this surgical technique be known as "Y-shaped cutaneous ureterostomy" instead of transureteral cutaneous ureterostomy because of its similarity to the method of Roux for Y-shaped digestive tract anastomoses, and because this new terminology is simpler and describes the operative procedure in a clearer manner.

Aged

Synthetic absorable sutures.

Based on the many reports published in the past several years, the synthetic absorbable sutures have been recognized as an important step forward in the history of suture materials. Synthetic absorbable sutures have been approved by the Food and Drug Administration for almost all surgical uses with the exception of certain cardiovascular and neurologic surgical procedures in which nonabsorbable sutures are mandatory, as, for example, in the suturing of a prosthesis to tissue. They have been used in many thousands of surgical operations of many types and show prospects of replacing other absorbable suture materials traditionally used in surgical operations. Moreover, because of their retained strength and low tissue reactivity, the synthetic absorbable materials are being used in some procedures in place of nonabsorbable materials. Thus, instead of using several different suture materials during some operations, the surgeon may find himself using one synthetic absorbable suture in different sizes for an entire procedure.

Abdomen

Minimizing postsurgical scars.

You will want to minimize postoperative scars for your and your patient's satisfaction. There are operative procedures and suturing techniques that will help you but, ultimately, a fine result can be most often obtained by meticulous attention to each detail, from the prep through the planning, the execution of the procedure, and the postoperative care.

Bandages

Single-stage reconstruction of urinary tract after loop cutaneous ureterostomy.

Three patients with four renoureteral units have undergone single-stage reconstruction involving ureteroureterostomy and ipsilateral ureteroneocystostomy following temporary loop cutaneous ureterostomy. Preliminary loop cutaneous ureterostomy diversion allowed adequate ureteral recompensation such that ureteral tapering was unnecessary in any of these cases. Rich collateral circulation as well as strict preservation of adventitial ureteral vasculature allows the performance of upper and lower ureteral procedures in a single session.

Dermatologic Surgical Procedures

Upper tract management when posterior urethral valve ablation is insufficient.

Of 105 boys with posterior urethral valves managed during a 10-year period most were managed by primary valve ablation. However, 39 of these boys required concomitant or additional procedures to 71 massively dilated ureters because of azotemia, infection and/or progressive upper tract deterioration. In 17 boys 25 ureters could be reconstructed primarily by varying degrees of ureteral tailoring. When there was severe infection, azotemia and/or doubt as to the function of the affected renal unit, staged reconstruction was initiated by cutaneous ureterostomy. One-fourth of these ureterostomy diverted children died of azotemia despite free urinary drainage. Those who went on to have staged reconstruction, despite multiple surgical procedures, retained intact urinary systems with acceptable function.

Bacterial Infections

A conceptual approach to local flaps.

Few procedures offer the surgeon a greater opportunity to exercise his surgical and aesthetic judgement than the design and implementation of local flaps about the head and neck. Considerations include skin color and texture match; adequacy of flap blood supply; size, location, and characteristics of the donor site defect; functional capability of the proposed flap; nature of skin tension lines created; and number of surgical procedures required. A systematic approach to local flap design and implementation is presented, and illustrations of the geometric principles involved are included.

Cicatrix

Modified Wheeler orbicularis overlap procedure for senile entropion.

Senile entropion is a condition involving the lower lid due to aging. Surgical correction has been directed to either increasing the vertical or horizontal tension on the tarsus. While all are good, each has its shortcomings with resultant recurrences. The procedure we are presenting is a combination of features which has given us the least recurrence rate. These include horizontal shortening of skin and orbicularis muscle and positioning of orbicularis straps so as to prevent their riding up on the tarsus. Figures illustrating the procedure in detail as well as pre and postoperative photos are shown.

Dermatologic Surgical Procedures

Tattoo removal with the carbon dioxide laser.

Our preliminary experience with tattoo removal utilizing the carbon dioxide laser at the Vancouver General Hospital is reviewed. We developed the method by trial and error until we produced a system yielding an acceptable procedure time with good results.

Adult

Some tips on face-lifting.

The face-lift operation is not difficult for the well-trained otolaryngologist. However, as in every surgical procedure, there are certain techniques that facilite its performance and improve results. This paper discusses some of these techniques that have been developed during the past 20 years.

Adipose Tissue

[Surgical treatment of loss of substance of the lower lip].

Repair of loss of substance of the lower lip has been the object of numerous studies. Each author has used his own ingenuity to describe a new type of flap aimed at restoring a particular form of loss of substance. The techniques suggested here are capable of solving a majority of problems on the basis of simple and original solutions. These flaps make it possible to resolve the problems posed by most cases of loss of substance of the lower lip. The choice of these plastic procedures permits restoration which is at one and the same time functional and anesthetic.

Dermatologic Surgical Procedures